眼球摘除联合义眼台植入术后并发症分析及处理  

Analysis and treatment of complications of eye enucleation combined with artificial eyeball implantation

作　　者：刘立民 燕新爱 程彦彦 任明玉 高宇 刘秀军 杨蕾蕾 高占国 

机构地区：[1]河北省眼科医院,邢台054001 [2]邯郸市第四医院眼科,邯郸056000

出　　处：《中国实用眼科杂志》2016年第2期175-178,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析眼球摘除联合义眼台植人术后的并发症原因，找出预防及治疗方法，以减少此类并发症的发生。方法回顾性分析2006年8月至2015年4月在河北省眼科医院收治的眼球摘除联合义眼台植入术后并发症的病例，结合临床及术中发现，寻找病因及预防、治疗方法。结果共18例病例。其中义眼台暴露7例，早期多为Tenon囊缝合欠严密所致，中期1例与缝扎肌肉的丝线与义眼片摩擦有关，晚期1例为义眼片较大压迫所致。结膜窦道1例，术中发现其与缝合外直肌丝线关系密切。结膜水肿2例，均发生于眼球摘除早期，加压包扎后治愈。眶内出血2例，均发生于术后3d内，给予对症治疗治愈。结膜肉芽肿3例，2例位于结膜表浅部，1例起自外直肌，眶内囊肿3例，术中均发现与眼外肌关系密切，将其完整切除。结论眼球摘除联合义眼台植入术后并发症由于手术时不注意细节所致，是可以避免的，术中仔细操作，可以极大限度地减少并发症的发生。Objective To analyze the complications of eye enucleation combined with artificial eyeball implantation and find the methods to avoid and manage it so as to cut down the complications. Methods Retrospective analyzed the patients with complications of eye enucleation combined with artificial eyeball implantation. The cause and the way of preventing and treating associated with clinical and intraopera!ive findings were to found. Results Eighteen cases of patients were collected in this study. Seven cases were implant exposure, the earlier causes were due to the Tenon capsule was not sutured watertight, and a middle stage due to the suture thread rubs against the prosthetic eye. A long period cause due to the prosthetic eye was too big and pressed the implant. One case of conjunctival sinus had close relation with the silk thread that sutured the lateral rectus muscle. Two cases of chemosis which occurred in the earlier stage of enucleation, it recovered after pressure dressing. Two cases of orbital hemorrhage occurred within 3 days of operation and were recovered after symptomatic treatment. There were 3 cases of conjunctival granulomas, among which two cases in the superficial conjunetiva, 1 case stem from the lateral rectus muscle. There were 3 cases of conjunctival cysts and all cysts were found originated from the rectus muscles and removed completely. Conclusions Most complications of eye enucleation combined with artificial eyeball implantation are due to carelessness during the surgery which can be avoided. Operating with great caution can decrease the complications greatly.

关 键 词：眼球摘除术 义眼台 并发症 预防 治疗 

分 类 号：R779.64[医药卫生—眼科]